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closure device

Marianne Brodmann, Andrew Holden, Thomas Zeller
PURPOSE: To evaluate the safety and feasibility of treating calcified infrapopliteal stenoses using an intravascular lithotripsy (IVL) system. METHODS: The Disrupt BTK study was a prospective, nonrandomized, multicenter, feasibility, and safety trial that enrolled 20 patients (mean age 79.0±9.6 years; 14 men) at 3 participating sites ( identifier NCT02911623). Fifteen patients had Rutherford category 5 ischemia, and all patients had moderate to severe below-the-knee arterial calcification...
June 1, 2018: Journal of Endovascular Therapy
Kavitha Odathurai Marusamy, Saravanan Ramasamy, Othman Wali
Early loss of permanent teeth, congenitally missing lateral incisors or second premolars, extremely displaced or impacted canines, all result in a reduced upper dentition. That leads to the development of crossbite in the maxillary dentition. Partial denture prosthesis, dental implants, and space closure by fixed orthodontics are the various means of treating the edentulous spaces. Protraction of molars is time taking and challenging. Temporary anchorage device (TAD) helps to protract molars without anchorage loss...
May 2018: Journal of International Society of Preventive & Community Dentistry
Leeann R Pavlek, Jonathan L Slaughter, Darren P Berman, Carl H Backes
Risks associated with drug therapy and surgical ligation have led health care providers to consider alternative strategies for patent ductus arteriosus (PDA) closure. Catheter-based PDA closure is the procedure of choice for ductal closure in adults, children, and infants ≥6kg. Given evidence among older counterparts, interest in catheter-based closure of the PDA in lower weight (<6kg) infants is growing. Among these smaller infants, the goals of this review are to: (1) provide an overview of the procedure; (2) review the types of PDA closure devices; (3) review the technical success (feasibility); (4) review the risks (safety profile); (5) discuss the quality of evidence on procedural efficacy; (6) consider areas for future research...
June 13, 2018: Seminars in Perinatology
Jeffrey S Kroin, Jinyuan Li, Sasha Shafikhani, Kajal H Gupta, Mario Moric, Asokumar Buvanendran
BACKGROUND AND OBJECTIVES: Infected implantable devices represent a clinical challenge, because the customary option is to surgically remove the device, and that is associated with substantial cost and morbidity to the patient, along with patient dissatisfaction with the physician. Although prophylactic systemic antibiotics and sterile technique are the mainstay of prevention of surgical site infection (SSI) after implant, the incidence of SSI remains relatively high. Although some surgeons add local antibiotic at implant site during surgery, there is no scientific research to demonstrate if there is a benefit...
June 13, 2018: Regional Anesthesia and Pain Medicine
Anat Lavie, Maya Ram, Shaul Lev, Yair Blecher, Uri Amikam, Yael Shulman, Tomer Avnon, Eran Weiner, Ariel Many
BACKGROUND: Preeclampsia is among the most common medical complications of pregnancy. The clinical utility of invasive hemodynamic monitoring in preeclampsia (e.g., Swan-Ganz catheter) is controversial. Thoracic impedance cardiography (TIC) and Doppler echocardiography are noninvasive techniques but they both have important limitations. NICaS™ (NI Medical, PetachTikva, Israel) is a noninvasive cardiac system for determining cardiac output (CO) that utilizes regional impedance cardiography (RIC) by noninvasively measuring the impedance signal in the periphery...
June 14, 2018: BMC Pregnancy and Childbirth
Akanksha N Thakkar, Ponraj Chinnadurai, John P Breinholt, C Huie Lin
A 63-year-old man with cirrhosis, hepatocellular carcinoma, and coagulopathy was diagnosed with a sinus venosus atrial septal defect (ASD) and partial anomalous pulmonary venous return (PAPVR) of the right upper pulmonary vein (RUPV). Transcatheter repair by positioning a stent graft in the superior vena cava was planned. Based on three-dimensional (3D) reconstruction of gated cardiac CTA, a 28 mm × 7 cm Endurant II® aortic extension stent graft (Medtronic, MN) was chosen. A 3D model printed from the CTA was used to simulate device deployment, demonstrating successful exclusion of the sinus venosus ASD with return of the RUPV to the left atrium (LA)...
June 13, 2018: Catheterization and Cardiovascular Interventions
Tatsuma Nomura, Akira Kamei, Shinya Sugimoto, Takaaki Morikawa, Jun Oyamda
No abstract text is available yet for this article.
June 12, 2018: Endoscopy
Nico Reinsch, Ute Ruprecht, Jochen Buchholz, Christoph Edel, Hagen Kälsch, Kars Neven
AIMS: Stroke due to atrial fibrillation has been associated with a high risk of disability and mortality. Percutaneous left atrial appendage (LAA) closure has been established as an alternative strategy for stroke prevention in patients not eligible for oral anticoagulation. The LAmbre is a novel occluder, specifically designed for LAA closure adaptive to various LAA anatomies. The aim of this study was to demonstrate feasibility and initial experience in a nonprescreened patient cohort for LAA occlusion using the novel LAmbre occluder...
June 11, 2018: Journal of Cardiovascular Medicine
Gerardo Musuraca, Pierfrancesco Agostoni, Emiliano Boldi, Ferdinando Imperadore, Clotilde Terraneo, Giovanni P Broso
: The migration of a percutaneous patent foramen ovale closure device is a very rare but serious complication. Late or very late embolization of device requires a different management strategy due to the inability of the device to deform to allow passage into a large caliber sheath compared with the early, periprocedural device migration. This last complication can normally be managed with snare and percutaneous retrieval.
June 11, 2018: Journal of Cardiovascular Medicine
C Linti, M Doser, H Planck, S Oberhoffner, E Mueller, M Renardy, J Biesinger, B Neumann, K Stang, T O Greiner, C Schlensak, S Krajewski, H P Wendel
Following percutaneous coronary intervention, vascular closure devices (VCDs) are increasingly used to reduce time to ambulation, enhance patient comfort, and reduce potential complications compared with traditional manual compression. Newer techniques include complicated, more or less automated suture devices, local application of pads or the use of metal clips and staples. These techniques often have the disadvantage of being time consuming, expensive or not efficient enough. The VCD failure rate in association with vascular complications of 2...
June 11, 2018: Journal of Materials Science. Materials in Medicine
Katy L Townsend, Jen Akeroyd, Duncan S Russell, Jamie J Kruzic, Bria L Robertson, William Lear
Objective: To compare the tolerability and mechanical tensile strength of acute skin wounds closed with nylon suture plus a novel suture bridge device (SBD) with acute skin wounds closed with nylon suture in a porcine model. Approach: Four Yucatan pigs each received 12 4.5 cm full-thickness incisions that were closed with 1 of 4 options: Suture bridge with nylon, suture bridge with nylon and subdermal polyglactin, nylon simple interrupted, and nylon simple interrupted with subdermal polyglactin. Epithelial reaction, inflammation, and scarring were examined histologically at days 10 and 42...
June 1, 2018: Advances in Wound Care
Joseph W Song, Jungwook Paek, Kyu-Tae Park, Jeongyun Seo, Dongeun Huh
Occlusion of distal airways due to mucus plugs is a key pathological feature common to a wide variety of obstructive pulmonary diseases. Breathing-induced movement of airway mucus plugs along the respiratory tract has been shown to generate abnormally large mechanical stresses, acting as an insult that can incite acute injury to the airway epithelium. Here, we describe a unique microengineering strategy to model this pathophysiological process using a bioinspired microfluidic device. Our system combines an air-liquid interface culture of primary human small airway epithelial cells with a microengineered biomimetic platform to replicate the process of mucus exudation induced by airway constriction that leads to the formation of mucus plugs across the airway lumen...
July 2018: Biomicrofluidics
Mehmet Akif Topcuoglu, Liping Liu, Dong-Eog Kim, M Edip Gurol
Cardiac embolism continues to be a leading etiology of ischemic strokes worldwide. Although pathologies that result in cardioembolism have not changed over the past decade, there have been significant advances in the treatment and stroke prevention methods for these conditions. Atrial fibrillation remains the prototypical cause of cardioembolic strokes. The availability of new long-term monitoring devices for atrial fibrillation detection such as insertable cardiac monitors has allowed accurate detection of this leading cause of cardioembolism...
May 2018: Journal of Stroke
Xavier Iriart, Vlad Ciobotaru, Claire Martin, Hubert Cochet, Zakaria Jalal, Jean-Benoit Thambo, Astrid Quessard
Atrial fibrillation is the most frequent cardiac arrhythmia, affecting up to 13% of people aged>80 years, and is responsible for 15-20% of all ischaemic strokes. Left atrial appendage occlusion devices have been developed as an alternative approach to reduce the risk of stroke in patients for whom oral anticoagulation is contraindicated. The procedure can be technically demanding, and obtaining a complete left atrial appendage occlusion can be challenging. These observations have emphasized the importance of preprocedural planning, to optimize the accuracy and safety of the procedure...
June 6, 2018: Archives of Cardiovascular Diseases
Saqib Zia, Kuldeep Singh, Amandeep Juneja, Jonathan Schor, Jonathan Deitch
PURPOSE: Transradial access (TRad) is becoming the preferred access for cardiac catheterization. The utility and safety of TRad in non-coronary and peripheral vascular interventions remains ill-defined and serves as the basis for this study. METHODS: Patients undergoing non-coronary and peripheral endovascular procedures via TRad from August 2010 to February 2013 at our institution were reviewed retrospectively. Demographic data, indications, interventions performed, sheath size, procedural outcomes and access site complications were evaluated...
June 6, 2018: Annals of Vascular Surgery
Thomas Fink, Michael Schlüter, Roland Richard Tilz, Christian-Hendrik Heeger, Christine Lemes, Tilmann Maurer, Bruno Reissmann, Laura Rottner, Francesco Santoro, Shibu Mathew, Andreas Rillig, Feifan Ouyang, Karl-Heinz Kuck, Andreas Metzner
BACKGROUND: Epicardial left atrial appendage (LAA) ligation may be an alternative to oral anticoagulation management and to endocardial LAA closure devices. We report long-term results after LAA ligation with the second-generation LARIAT device. METHODS: Retrospective study was performed on patients who underwent LAA ligation at our center. Follow-up included patient visits and transesophageal echocardiography (TEE) to assess LAA-to-LA leakages. RESULTS: 76 patients with an indication for LAA closure underwent cardiac CT-based screening with 16 patients (21%) excluded from LAA ligation due to anatomical reasons...
June 7, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Roberto Negrín, Nicolás O Reyes, Magaly Iñiguez, Juan José Pellegrini, Mauricio Wainer, Jaime Duboy
Posteromedial meniscotibial ligament lesions, known as meniscal ramp lesions, are typically associated with ACL injuries, but frequently underdiagnosed. When correctly diagnosed, repair is mandatory in most cases. Retraction of the soft tissues makes it difficult to repair and leads to suture failure. Previously described techniques include all-inside and inside-out meniscal sutures, but do not ensure correct meniscotibial closure because of the soft tissue retraction. The purpose of this Technical Note is to describe a meniscal ramp lesion arthroscopic repair with an all-inside technique with the Fast-Fix 360 device, detailing the use of the accessory posteromedial portal, and the addition of an arthroscopic grasper that raises the retracted meniscotibial ligament, to allow correct fixation...
March 2018: Arthroscopy Techniques
Ashish H Shah, Mark Osten, Lee Benson, Sami Alnasser, Yvonne Bach, Rohan Vishwanath, Alex Van De Bruaene, Healey Shulman, Jeneka Navaranjan, Rafique Khan, Eric Horlick
OBJECTIVES: The aim of this study was to assess the incidence of persistently positive results on agitated saline contrast injection after patent foramen ovale (PFO) closure, the underlying mechanism, and management. BACKGROUND: Transcatheter intervention to close a PFO is reasonable in highly selected patients younger than 60 years, after a thorough cardioneurological investigation following a cryptogenic stroke, particularly in the presence of thromboembolic disease or in patients at high risk for venous thrombosis...
June 11, 2018: JACC. Cardiovascular Interventions
Michael D Gudejko, Brian R Gebhardt, Farhad Zahedi, Ankit Jain, Janis L Breeze, Matthew R Lawrence, Stanton K Shernan, Navin K Kapur, Michael S Kiernan, Greg Couper, Frederick C Cobey
BACKGROUND: Severe right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation increases morbidity and mortality. We investigated the association between intraoperative right heart hemodynamic data, echocardiographic parameters, and severe versus nonsevere RVF. METHODS: A review of LVAD patients between March 2013 and March 2016 was performed. Severe RVF was defined by the need for a right ventricular mechanical support device, inotropic, and/or inhaled pulmonary vasodilator requirements for >14 days...
June 5, 2018: Anesthesia and Analgesia
Jun Hu, Hope K Haefner
Vulvectomies often require removal of large areas of vulvar skin, which may result in problems with wound healing, including infections and scarring. At times, skin grafting is needed following a vulvectomy, and for large excisions, a Foley catheter and rectal tube are often required. Vacuum-assisted closure (VAC) for vulvectomy, with or without skin grafting, has been used for a variety of vulvar conditions. The difficult portion of performing these procedures, with the use of the wound VAC, is obtaining an adequate seal around the Foley catheter and rectal tube...
April 2018: Plastic and Reconstructive Surgery. Global Open
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